premedicine

AMCAS II Ex. 6 — When Have you Faced Criticism?

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Eventually along the way you’ll find a secondary question asking you about how you deal with criticism. It’s an  important question for innumerable reasons. The question for this essay is pretty much asking you, “Have you learned how to accept criticism and then do something constructive without having tantrum?” Medical students receive critiques to hone their skills prior to being flung into residency.  Once there in their internship, they’ll be a lot more of it, most will be legit some unwarranted. Other physicians may criticize new interns, these new doctors find themselves bombarded by critiques that are no longer didactic exercises, but are now instead life and death lessons. Patients will berate you for being late, how could they know you were doing chest compression upstairs in room 215 for 20-minutes?  But, without getting too far ahead of ourselves, let’s just remember that the medical school wants to see how you will handle criticism when they dish it out to you — there is also an undertone of show your maturity here please.

If you’re not used to handling criticism, you should get used to it. I finally learned what criticism meant when I was just accepted as the co-principal investigator for a project. I turned in my research thesis for my senior project to my principal investigator. He gave it back a few weeks later, but for some reason he had changed all of the font to red. I was wrong, he meant the whole thing had to be scrapped. I faced more criticism during lab meetings where we had to present new or class electrophysiology research articles and our interpretation. After some time, you just learn how to take criticism and become better from it. If there’s room to criticize then there’s room for improvement.

During this essay you’ll try to do several things:

1. Show that you know how to take criticism, i.e. you don’t bite off people’s jugulars when they give you an honest critique.

2. Show that you understand that accepting criticism can be a learning experience — this can be true regardless of who’s “right or wrong”.

3. You can show that you have some real world experience, i.e. will the school also need to teach you “life skills” or do you already have some.

Tell us about a time where you’ve received unexpected feedback or critique. And, how did you react to the situation?

As an Institutional Review Board (IRB) [title redacted] my first and foremost goal is to ensure that research projects meet ethical and regulatory standards. However, principal investigators (PI) often have disparate concerns, namely the timely completion of their investigative study. In one particular protocol conducted by a well-established (PI) I found the protocol didn’t meet my interpretation of ethical compliance. In response, I received a deluge of emails noting my incompetence; it became apparent to me that my review didn’t sit well with my (PI) colleague. I’m not infallible, and there’s a lot of “grey areas” in law interpretations, so I launched an investigation into my own decision. I poured through ethical reference texts and case studies to establish an ethical precedent for my decision, after I proved my case I reported my findings to the IRB and PI. After the protocol was modified, the study was approved and I have a good working relationship with that same PI.

The hardest part of this entry was actually writing it in such a way that I could still be professional, and be certain to represent both sides of the argument. Also note that I decided to not defend some of the criticisms against me, and instead accept it and show how I grew from it.

Good luck!

Several Ways to Avoid Being Accepted

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Today’s post will be dedicated to some pitfalls of applying to medical school.

This won’t be some long rant about how difficult or unfair the medical school applications process is, I’m likely biased as an accepted student, but I think it’s a decent system considering the amount of applicants they have to filter through. There are a lot of reasons for you to get rejected from medical school, you’ll really have to get used to this — getting into the placid lakes of acceptance(s) usually equates to paddling through the roaring rapids of rejections. Unfortunately, some people are tossed off the raft prematurely by some schools whether it’s your fault or not. Sure, there’s hiccups in the medschool application process, but be realistic and dare I say pragmatic about how things work. The process is flawed admittedly, but people are flawed so these was inherit in the process. However, there are things you can do from your end to give yourself the best shot at NOT being rejected:

Self Select Out

ejection-seat-af-acesii
“What? It costs how much..? What 8 more years at least of education?!”

 

Let me be the first to say this, “Deciding not to go to medical school is in no way a failure“, there are perfectly sane reasons to decide against going. For example, I had one friend who was dead set on being doctor due to a cancer death in her family. She went to an ivy league, had the brains and the grades, and ambition. In fact, she’s probably one of the most ambitious people I’ve ever met — seeing her actually motivated me. But, as the decision grew closer, she decided to go get a PhD. She decided to devote her career on pure, unadulterated, bench research to find a cure for the disease that struck her mother down. You don’t have to go win a Nobel Peace Prize instead of applying to medical school to compensate, it’s just that you should realize there are comparable ways to be happy. It’s very important that you are cognizant about your decision, to deliberately give up a lot of your life to become a physician. I’m proud of the people who were brave enough to leave the pre-set rails and find their own answer to happiness, I left mine to become a medical student — I self selected out of graduate school. Of course I’m not trying to talk you out of applying, be realistically most people who are premeds never in fact go onto apply to medical school at all. If you don’t mash the eject button, and you’re a statistically good applicant, then you do have a little worse than a coin toss of a chance of being accepted into a program at all (though each school has a much lower acceptance rate); that might sound terrible, but if I said you have “a little worse than a coin toss of a chance of being hit by a car if you cross the street” I bet you wouldn’t think the odds so slim. So, if you did stuck with it have some solace there, if anything.

Money, it’s just not in your budget this year

You have to pay to play.
You have to pay to play.

I actually hate saying this part, but money is the “rate limiting step” of applying to medical school. So, you really have to sit down and make a plan about both how you’ll be applying and will be affording to apply. There are financial assistance programs, if you qualify then I believe that’ll cover your primary and secondary application costs (limited to about 15 schools). This will not cover your plane tickets, but some schools have host programs, so you can pare you costs here and there. The caveat here is that the program considers your parents income, regardless of your independence or age. And, in the shrinking middle class there’s a good chance your family, on paper, is well above the poverty line but in reality your family is just a job loss or a check away from utter financial collapse. In other words, there’s a chance you won’t qualify for assistance, even if you need, so don’t hedge your bets — you should make adequate financial plans to ensure you have enough money to survive the costly process. Unless you have a “guaranteed in”, and are doing the “early selection” process to one school applying to 3-schools because that’s all you could afford would most likely make you a re-applicant the next cycle. If the money didn’t happen for you this year, there’s no shame in being broke, you can use that gap year to make money and improve your AMCAS application. If it’s any consolation, when you become a doctor everyone will think you probably never had a poor day in your life — wait that’s not a consolation…

Apply to schools that don’t think fit you

Never bring a  knife to a gun fight -- unless it's a knife-gun taped together.
Never bring a knife to a gun fight — unless it’s a knife-gun taped together.

What ever algorithm you decide to go with while applying to medical school, make sure it’s pragmatic. You should invest the $25 into the MSAR, get full access, and see if you having a seat at a particular school seems reasonable. In the MSAR each school will show their ACTUAL (all the way from the top to bottom 10%-tile) GPA and MCAT scores of the previous admitted class, somehow this is usually different from the numbers presented at the school’s actual website (depending if they decide to list the mean or the median, and if they decide to tell you that on the website). So, if you apply half blind your risk either applying to more “reach” schools then you expected, on the other hand you may miss applying to good programs. There’s a lot of gossip about what scores actually want, avoid that stuff, instead go straight to the source and see how well you line up. For example, are you applying to a program where 90% of the accepted students had research experience? Yet, you focused entirely on clinic hours and your primary and personal statement you let out a nuanced defensive sentiment of how much more important you felt clinic experience was in comparison to that “silly lab nonsense”. Well, your admissions officer might be one of those silly research people. While, if you did the same thing (without being politically incorrect) at a school that allocated about zero funding to research then it wouldn’t be so bad. Though, as a pro-tip: never insult another profession or pursuit of happiness in your AMCAS or interview.

You might want to go to all of your dream schools, but maybe you should diversify your stock portfolio.

Apply to too many/too few schools

This is either a typical bell curve, or a cat hiding under a sheet -- your pick.
This is either a typical bell curve, or a cat hiding under a sheet — your pick.

Think of it this way, let’s imagine the bell curve only correlates to the number of schools and the process of applying and nothing else (pretending all else is equal). Most people apply to 15-20 schools, these people normally have success — so, then conceptually they are the center of the bell curve. Of course the qualification here is that perhaps they were going to get in anyways, and they happend to just pick the typical amount of schools. The left side of the bell curve represent the people who didn’t apply to enough schools, for example I’ve met people who’ve applied to less than 7 schools. They applied to a few schools because they were a strong applicant statistically, they didn’t account for some schools just outright rejecting you. Assuming the had a great interview season they would of been interviewed by 1/3 to 1/2 of those schools they applied to. They received interviews, and were rejected. Once you are actually interviewed your chances of getting in go up a lot, so if they had rolled more dice they might of had a different fate. On the other hand, on the right side of the curve, I’ve been told an anecdote where a person applied to around 50 schools, barely pulled a few interviews, and get into none of them — despite having decent stats. There are perfectly valid ways to approach 50 schools and not be off your rocker, if you started very early and applied to both MD and DO programs. But, this person likely just fired from the hip and hoped some medical school would notice them. That works okay in the primary, but the secondary is brutal, and they’re screening out for people who “really don’t want to be there”, remember it’s not like they can’t find someone who actually cares about the program.

Apply when your not ready

Just because you "can" doesn't mean you're "ready".
Just because you “can” doesn’t mean you’re “ready”.

As I already stated, in this article, there’s a lot to prep for when applying to medical school. But, few people really consider if they’re personally ready to apply to medical school. This is different from finances, stats, and CV talking points. Are you emotionally/mentally ready for the process? if your not ready, you risk putting in a half-heart application. And as weird as this sounds, if you get rejected from medical school you at least want to know that you put your best foot forward. Maybe the support you thought would be there during your applications (emotional) won’t be there. I have one friend who’s family treats her as a failure during her graduate school application process because she doesn’t have a baby, not interested in getting married, and *gasp*  is past her mid-twenties.  I have another friend who feels like they’re pushed off a cliff into applying because both their parents invested so much in them. You may have a lot on your plate to deal with besides the typical application stuff. Personally, I had a friend in my research cohort (also a premed) commit suicide, and my grandmother die (in an unethical medical manner) a month apart, I needed time off.   I took a gap, and just spent more time doing community service (tutoring children for free, tutoring at prisons and academic advising, teaching science at children’s hospital) and got a job as an IRB/ACUC ethics officer. I think if I had just applied when people were coaxing me to apply then I would of been rejected anyways because I wasn’t in the right mind set. Sadly, I learned this lesson only after I could advice friends against it, because I’ve seen many friends put in a weak application (perhaps subconsciously) because they’re overwhelmed with life/responsibilities. The caveat here is that you want to be able to document some type of progress or commitment if you have to take a gap year. In medical school and in practice you’ll have less time to recover, so if you have a bone to pick deal with it now if you have to take a gap year.

You apply too late

Some will get left behind.
Some will get left behind.

Applying too late in the cycle (September and on) for most MD schools is a good way to ensure you have to re-apply the next cycle. I can’t emphasize enough: you can be a great candidate and still be rejected. There are a limited number of seats, for every person that gets admitted before you is one more seat you can not have — it’s the biggest game of musical chairs you’ve ever played. If you join the game late then you’re playing by a different set of rules, it’s a less friendly game towards the end of the song. Whatever year you decide to apply, sit down and make a schedule to ensure you’ll be ready to put an application in within the first two weeks of the opening of the AMCAS primary application. Its takes a few weeks for the AMCAS to send your applications to schools, this year perhaps around June 28th (though it’s been known to get pushed back I wouldn’t bet on it), they are all released at the same time if your application is both verified and ready to be sent to schools. So while you should apply early, don’t be a fool and put in a low quality application trying to beat the rush. Once you’ve submitted you can’t change most things, the only thing you can change really is adding more schools to your selection list — so apply early but don’t put in a poor product, the key to this is working on your applications early.

You put in a bad or inconsistent application (including interview day)

Try to be one person, pretend to be sane if not for just the AMCAS.
Try to be one person, pretend to be sane if not for just the AMCAS.

If you seem like three different people during your 1) primary, 2) secondary and 3) if you get interviews don’t be surprised if schools don’t curry for your favor. It’s important to be congruent throughout the process of applying. Your primary might shine, but your secondary might have so many grammatical flaws or rhetoric flaws that admissions committee wonder how it’s possible you’re the same person. Interview day starts when you get off the airplane. When you’re in town, you’re a guest of the medical school as a potential future physician for their community. With that in mind, when your burst in the door to meet the staff your best treat them well, not to kiss up, but because you’re hopefully that respectful and humble person you kept droning on and on about during your applications. When you interview, remember why they summoned you there — key word summoned. They wanted you there, so just be the person on the application. Hopefully, you and that person are the same, or you have a lot of reconciling to do.

**

Try avoiding running into this pitfalls, and all you have to worry about is the stuff you expected to be worrying about.

Follow me @doctororbust

Pressing the Submit Button – #AMCAS

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Certainty — there is such an irony in the word “certainty”, as few things in life are ever certain. 

Image

Though, there is some overarching truths inherent to every premeds journey, or certainties: prerequisites, volunteering, and some type of leadership and/or some other types of enrichment experience. And, again we edge closer to certainty as we mature along our premed journeys’, after all there’s a lot less certainty of a freshman premed continuing on into medical school than a premed senior/post graduate. The reasons are pretty blatant, and don’t need much exploration: the premed journey whittles down a lot of people, regardless of your beautiful mind and/or heart, and by the time you reach the end you’re probably a ‘decent’ applicant if you stuck with it and life didn’t molest you too obtrusively. A lot of great people never make it to taking Organic Chemistry, the gnarled and tattered survivors go onto take the MCAT. The socially emaciated, #MCATPTSD desiccated husks of people,  formerly known as a premed, then goes onto enter the must brutal game of musical chairs i.e. the AMCAS. At that time, if you chose to apply then you are now an applicant — this nebulous “friend” zone where you’re still a premed, but you are “certainly” a premed after you’ve pressed the SUBMIT button on the AMCAS.

Before pressing the submit button, early in a premed’s career the title “premed” is one often wore in honor. For the medical school applicant premed, this is probably the most fearful time in their life, and the title suddenly bears great weight. In fact, there’s likely a strong correlation to how many people expect you to become a doctor your perceived Atlas boulder on your neck. Indeed, I’d argue there’s even some type of transcendental comradery that is threaded between applicants and accepted medical students (and even doctors), a mutual respect borne through similar experience regardless of outcome.

Let me assuage your concerns, it’s perfectly normal to be apprehensive about applying to medical school, there is no shame in it. Indeed, it’s better to have every doubt you can conjure up prior to being accepted into medical school — and even then the doubts probably won’t stop stirring. This is probably especially true if your parents have geared you up to be a premed since you were a fetus because this is likely the first time you realized the destination of your train tracks. There was little certainty when you started your career as a premed that you’d end your undergraduate career as one (if traditional), and there is little certainty that when you press submit you’ll get in. And really, there is a maturity involved in re-evaluating your life, after all the true path to medicine forged you own way.

But, there is one sure way to be certain you won’t get in, by sabotaging yourself (perhaps unconsciously) by putting in a low grade application effort on the AMCAS or self-selecting out. And its fine to decide to do something else, this is in no way a failure, the most important thing is that you consciously choose and don’t let the sands of fate do as they may.

Though know there is one certainty: the only way to get into medical school is to apply to medical school.

 

 

Personal Statement — How to Get That First Draft – 6 Simple Rules

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*I used the first rule right now*

Recently, after I responded with comments for a reader’s Personal Statement, I received a follow up email with the question of “Just how do you get started on a draft in the first place?”. Good question, so that’s the topic of this entry.

After graduating college I was looking for a job, I saw a position as content writer for: nutrition, health, and technology. Since I had never written for cash before, had no editorial experience, I naively submitted one of my writing samples from my lab days after several glasses of wine at 4 AM. About a month later, I received a call an editor, a phone interview was held, and I was hired on as a content writer. What I didn’t know is that typically people pull off an internship or two before asking for cash, so I had to pull out all of my procrastination lessons learned in college to write my almost 100 contributed articles.

Rule 1 — Write the conclusion first: it’s often pretty hard to start writing, but once you start things do seem to roll down hill from there. Never the less, the activation energy required for the first draft is through the roof (if that reference went over your head you’d best make sense of it before the MCAT). A common question you’ll receive if you receive a primary or secondary application is where do you see yourself in 10 years? That answer to that question is an excellent conclusion. Move past just “getting in”, project to what you’ll do with your credentials. Don’t oversell your future (don’t say I’ll win 34 peace prizes), but do let them know why admitting you would help the community. Since you know where you’re going building the rest of the plot/premises shouldn’t be that difficult.

Rule 2 — Identify about 3 premises that explain your argument, qualify premises don’t pontificate your point.

The best way to get a rational person to ignore your rational premises is to argue them in an irrational way. You could rebut, but wouldn’t it be irrational to ignore someone’s rational premise based on the pretty package it came in — well, tell bad, if you can’t communicate effectively then you’re ship sinks before it sails. Stick to a few points, don’t make a laundry list, it’ll make you sound like your either over compensating or didn’t have that much depth of involvement. If you can’t pick 3 premises, that’s fine, just make a huge draft with all of them, then go back with critical friends and identify the best ones that lead congruently to the ending in your conclusion. Though, the premises you do choose should improve/fill gaps in your application, since the process of acceptance is rather holistic.

Rule 3 — Beat your reader to the punch when it comes to weaknesses in your argument.   

Currently my job is in ethics and risk assessments for research involving animals and research. As such, I spend all day reading people’s research protocols with them trying to obscure their weaknesses in their applications (not always true). People want to graduate, and often they feel I am the golem blocking their path, so some feel maybe if they had their weakness then maybe I won’t notice. This is wrong, I still notice, but now I also think you have something to hide. The same went for when I wrote articles, or wrote lab write ups. You’re a lot more convincing when you’re critical. Critical doesn’t mean you abuse yourself, it means you see both sides of the coin. So, it’s okay to bring up bad grades/scores, just leave it to one or two sentences. Above all else, own up to it, but it is okay to explain how it happened. But, it wouldn’t matter if Godzilla came and gobbled up your organic professor and your “deserved grade”, even if you don’t know where Godzilla came from it’s best to just say “damn, but won’t happen again, learned my lesson” than “woe is me”. With that in mind, remember to not over compensate for those weaknesses (everyone has a boo-boo on their application).

Rule 4 — Never write without an outline made from the premises brainstormed in Rule 2. Maintain a separate simplified outline, and feel free to move the outline premises around as you please. Keep outline short, it’ll make sure things keep fluid — the longer your outline becomes the more useless it becomes IMHO. 

Being aware of your premises, and having a structure will help prevent wasteful passages,sentences, and structures. It will also help get rid of redundancies. Let’s face it, things are almost always clearer from afar than up close, i.e. outline versus the actual draft.

Example outline (note that while the conclusion is at the end, the premises can be slide around or removed completely):

– Conclusion: accepted into medical school, training interns as resident, fellowship, community center for public health education for BP/diabetes etc. (note, I wrote this first, I actually had no idea what to write, and the rest just came)

– Premise 1: establish why I want to go no matter what – qualify with life long learning examples in X, show with examples of hospital where I helped X and learned X.

– Premise 2: establish I got the brain fire power, and I can stand after failure – qualify with slight mention of awards, after and only after first telling about my initial hardships to make sure I establish an upward trend in the narrative. Maybe mention some research here, let the research speak for itself. Help establish why I have the muster for how hard medschool will surely be.

– Premise 3: establish that I understand what service is, make my essay service oriented. — mention hosptial volunteering exp (related to premise 1), and correctional facility volunteering for non med community, make sure I explain the lessons learned to become a better physician/medstudent.

Rule 5 — Write the introduction last.

Golden Rule: Always know where your PS is going, knowing your conclusion will set you up for this. And, with a solid outline, and a draft with elements to qualify your response writing the conclusion typically isn’t that bad. Writing the first sentence may be difficult, but after you’ve seen your whole draft its a lot easier to “capture” the spirit in the introduction.

Rule 6 — Never procrastinate. 

Never rush a piece of art. Rushing at the end will only end in your despair. If you outline early, work with premises early, then the PS just sort of falls together over time. But, it falls together in a beautiful way. If you rush it, it’ll show in the editing/structure/premises/arguments/style, why rush the most important PS you’ve ever written? If you pace out your work writing a PS is actually quite systematic, albeit meticulous, process. A bad PS is a great way to get rejected.

Good luck!

#doctorbust